Principles for managing penetrating craniocerebral injuries caused by firearm missiles

Penetrating craniocerebral firearm injuries remain one of the most lethal causes of all trauma and are common both in war or peace time. Data were reviewed for 4140 severely head-injured patients (Glasgow Coma Scale (GCS) scores 3-8) treated at Xi-Jing Hospital between 1973 and 1993; 51 of these patients had acute penetrating craniocerebral injuries caused by firearm missiles. These patients consisted of 46 males (90.2%) and 5 females (9.8%) ranging in age from 3 months to 48 years (median 22.4 years). The lesion types included 2 tangential wounds, 37 tubular wounds and 12 through-and-through wounds. All cases were urgent with the patients in severe and unstable states. After emergency treatment and operation, 5 cases died (9.8%). Follow up studies at three months showed that 23 cases (45.1%) had made a good recovery. Moderate disability, severe disability and vegetative states in this series were 29.4%, 13.7% and 2.0% respectively. Long term follow up studies indicated that 32 were able to resume their occupation. The principles for managing penetrating craniocerebral firearm injuries and suggestions for operation are discussed.     

脑干区占位病变的手术入路

本文报告了1990年5月以来脑干区大型、复杂占位病变15例.其中,位于脑干内3例,脚间窝2例,岩尖部4例,全岩骨区1例,全斜坡区2例,第四脑室内3例.本组采用以扩大了的岩骨入路为主的联合入路,行肿瘤全切除8例,次全切除5例.2例仅作了活检加减压术.除1例死亡外,均恢复良好.本文结合文献,对脑干区手术入路进行了讨论.     

Juvenile Xanthogranuloma on the Palm

Abstract: Juvenile xanthogranuloma is a xanthomatous and granulomatous condition that frequently arises before 1 year of age and mainly occurs on the head and trunk. We report a rare solitary juvenile xanthogranuloma on the right palm of a 10-year-old girl, present for one year. This solitary involvement of the palm has been reported only twice before.     

Computerized tomography based on DEI refraction information.

Conventional computerized tomography (CT) technique is based on the absorption contrast. In recent years, X-ray phase-contrast CT (PCCT) has been developing rapidly. It uses the phase information to reconstruct the object and provide high contrast and spatial resolution. Diffraction enhanced imaging (DEI) method is one of the three phase-sensitive X-ray imaging techniques. DEI method employs an analyzer crystal to extract the object's refraction information which can be used for CT. However, when DEI refraction CT is combined with the conventional CT algorithm, it should be satisfied that the refraction information of an arbitrary point in the object is invariable at every projection view. In this paper, the invariance condition of refraction information is analyzed and two feasible methods are provided for reconstruction. Using these two methods, two samples of weak absorption are reconstructed with the experimental data obtained at Beijing Synchrotron Radiation Facility (BSRF).     

用酶联免疫吸附术观察向附睾注射鱼肝油酸钠后抗精子抗体的变化

本研究用酶联免疫吸附术观察8只家兔在附睾注射鱼肝油酸钠后血清及精浆中的抗精子抗体。血清抗精子抗体阳性率为37.5～50.0%,最早检出率为术后2个月,6～7月达高峰。精浆抗精子抗体阳性率为25%,最早检出率为术后4个月,且此时己达高峰。与输精管结扎资料相比,发现血清抗精子抗体检出率偏低,而精浆相应抗体偏高,表明向附睾注射鱼肝油酸钠引起的免疫反应有别于结扎,以生殖道局部为主。     

美国医院的集团化运作

自1923年以来的这段时间,是医院发展史上最具探索性的时期.许多医院因为严峻的经济大环境而艰难度日,住院率低下,公益负担日增,融资渠道日益萎缩,私立机构的状况更是让人揪心,前景看起来一片黯淡.然而所幸的是,每次经济危机也带来了新的观念和方法.医院在逆境中反思,逐渐改变旧有的行为方式,引入商业运营模式,学会当家理财.